Socioeconomic Status Affects Pre- and Postoperative Two-point Discrimination in Patients with Carpal Tunnel Syndrome
Carpal tunnel release is a life-changing procedure within hand surgery. Multiple factors may have an impact on the outcome following surgery. MethodsIn this retrospective cohort study, we reviewed all patients who underwent carpal tunnel release in our institutional database from 2018 to 2020. We in...
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Published in | Plastic and reconstructive surgery. Global open Vol. 10; no. 7; p. e4389 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Hagerstown, MD
Lippincott Williams & Wilkins
08.07.2022
Wolters Kluwer |
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Abstract | Carpal tunnel release is a life-changing procedure within hand surgery. Multiple factors may have an impact on the outcome following surgery. MethodsIn this retrospective cohort study, we reviewed all patients who underwent carpal tunnel release in our institutional database from 2018 to 2020. We included patients with a minimum of 6-week follow-up. Patient demographics were identified, including insurance status and comorbidities. Patients were categorized as "improved" or "not improved" based on two-point test differences. Results were analyzed using the Fisher exact test. We ran a logistic regression model to analyze the relationship between income status (operationalized by having Medicaid/Carelink) and preoperative scores, and inferential statistics were computed with appropriate t tests. ResultsOf the 125 patients who met the inclusion criteria, 47 (37.6%) had Medicaid or Carelink, and 79 (62.4%) had commercial insurance. Medicaid/ Carelink patients presented with worse two-point discrimination on initial presentation (P < 0.001). Compared to commercial insurance, Medicaid/Carelink patients were less likely to show improvement in postoperative two-point discrimination (P < 0.001). Male patients were also less likely to show improvement. Race, ethnicity, medical comorbidities, and age were not shown to have a significant effect on improvement in two-point discrimination. ConclusionsAlthough medical comorbidities did not have a significant effect on postoperative two-point, patients with low-income status (Medicaid/Carelink) may have a less predictable outcome. These socioeconomic considerations are critical in appropriately risk stratifying surgical candidates, and counseling patients in whom tactile acuity may be less predictable. |
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AbstractList | Background:. Carpal tunnel release is a life-changing procedure within hand surgery. Multiple factors may have an impact on the outcome following surgery. Methods:. In this retrospective cohort study, we reviewed all patients who underwent carpal tunnel release in our institutional database from 2018 to 2020. We included patients with a minimum of 6-week follow-up. Patient demographics were identified, including insurance status and comorbidities. Patients were categorized as “improved” or “not improved” based on two-point test differences. Results were analyzed using the Fisher exact test. We ran a logistic regression model to analyze the relationship between income status (operationalized by having Medicaid/Carelink) and preoperative scores, and inferential statistics were computed with appropriate t tests. Results:. Of the 125 patients who met the inclusion criteria, 47 (37.6%) had Medicaid or Carelink, and 79 (62.4%) had commercial insurance. Medicaid/ Carelink patients presented with worse two-point discrimination on initial presentation (P < 0.001). Compared to commercial insurance, Medicaid/Carelink patients were less likely to show improvement in postoperative two-point discrimination (P < 0.001). Male patients were also less likely to show improvement. Race, ethnicity, medical comorbidities, and age were not shown to have a significant effect on improvement in two-point discrimination. Conclusions:. Although medical comorbidities did not have a significant effect on postoperative two-point, patients with low-income status (Medicaid/Carelink) may have a less predictable outcome. These socioeconomic considerations are critical in appropriately risk stratifying surgical candidates, and counseling patients in whom tactile acuity may be less predictable. Carpal tunnel release is a life-changing procedure within hand surgery. Multiple factors may have an impact on the outcome following surgery. Carpal tunnel release is a life-changing procedure within hand surgery. Multiple factors may have an impact on the outcome following surgery. MethodsIn this retrospective cohort study, we reviewed all patients who underwent carpal tunnel release in our institutional database from 2018 to 2020. We included patients with a minimum of 6-week follow-up. Patient demographics were identified, including insurance status and comorbidities. Patients were categorized as "improved" or "not improved" based on two-point test differences. Results were analyzed using the Fisher exact test. We ran a logistic regression model to analyze the relationship between income status (operationalized by having Medicaid/Carelink) and preoperative scores, and inferential statistics were computed with appropriate t tests. ResultsOf the 125 patients who met the inclusion criteria, 47 (37.6%) had Medicaid or Carelink, and 79 (62.4%) had commercial insurance. Medicaid/ Carelink patients presented with worse two-point discrimination on initial presentation (P < 0.001). Compared to commercial insurance, Medicaid/Carelink patients were less likely to show improvement in postoperative two-point discrimination (P < 0.001). Male patients were also less likely to show improvement. Race, ethnicity, medical comorbidities, and age were not shown to have a significant effect on improvement in two-point discrimination. ConclusionsAlthough medical comorbidities did not have a significant effect on postoperative two-point, patients with low-income status (Medicaid/Carelink) may have a less predictable outcome. These socioeconomic considerations are critical in appropriately risk stratifying surgical candidates, and counseling patients in whom tactile acuity may be less predictable. |
Author | Rose, Ryan Momtaz, David Prabhakar, Gautham Ghali, Abdullah |
AuthorAffiliation | Department of Orthopedics, Baylor College of Medicine, Houston, Tex From the Department of Orthopaedics, UT Health San Antonio, San Antonio, Tex |
AuthorAffiliation_xml | – name: From the Department of Orthopaedics, UT Health San Antonio, San Antonio, Tex – name: Department of Orthopedics, Baylor College of Medicine, Houston, Tex |
Author_xml | – sequence: 1 givenname: Gautham surname: Prabhakar fullname: Prabhakar, Gautham organization: From the Department of Orthopaedics, UT Health San Antonio, San Antonio, Tex – sequence: 2 givenname: Abdullah surname: Ghali fullname: Ghali, Abdullah organization: Department of Orthopedics, Baylor College of Medicine, Houston, Tex – sequence: 3 givenname: David surname: Momtaz fullname: Momtaz, David organization: From the Department of Orthopaedics, UT Health San Antonio, San Antonio, Tex – sequence: 4 givenname: Ryan surname: Rose fullname: Rose, Ryan organization: From the Department of Orthopaedics, UT Health San Antonio, San Antonio, Tex |
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Snippet | Carpal tunnel release is a life-changing procedure within hand surgery. Multiple factors may have an impact on the outcome following surgery. MethodsIn this... Carpal tunnel release is a life-changing procedure within hand surgery. Multiple factors may have an impact on the outcome following surgery. Background:. Carpal tunnel release is a life-changing procedure within hand surgery. Multiple factors may have an impact on the outcome following surgery.... |
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Title | Socioeconomic Status Affects Pre- and Postoperative Two-point Discrimination in Patients with Carpal Tunnel Syndrome |
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